笑气联合局麻在阻生牙拔除中的应用效果评价

doi:10.19438/j.cjoms.2024.02.009

摘要/Abstract

摘要： 目的: 评价笑气联合局麻在阻生牙拔除中的应用效果及对患者焦虑心理的影响。方法: 选择2021年12月—2022年12月在绍兴市口腔医院进行阻生牙拔除的患者188例,随机分为试验组和对照组,每组各94例。对照组采用局麻拔牙,试验组采用笑气联合局麻拔牙。比较2组患者在局麻时、拔牙时及拔牙后5 min的心率（HR）、Ramsay镇静评分和疼痛VAS评分,并比较2组患者的改良牙科焦虑评估量表（MDAS）评分和治疗后舒适度。采用SPSS 22.0软件包对数据进行统计学分析。结果: 随着治疗时间变化,2组HR呈现先升高后降低趋势（P<0.05）。局麻时、拔牙时、拔牙后5 min,试验组HR显著低于对照组（P<0.05）,试验组MDAS评分显著低于对照组（P<0.05）。随着治疗时间变化,2组Ramsay镇静评分呈现先降低后升高趋势（P<0.05）。局麻时、拔牙时、拔牙后5 min,试验组Ramsay镇静评分显著高于对照组（P<0.05）。随着治疗时间变化,2组VAS评分呈逐渐升高趋势（P<0.05）。局麻时、拔牙时、拔牙后5 min,试验组VAS评分显著低于对照组（P<0.05）,试验组舒适度显著优于对照组（P<0.05）。结论: 笑气联合局麻用于阻生牙拔除能降低HR,改善患者焦虑心理及镇静状态,减轻疼痛程度,提高舒适度。

关键词: 笑气, 微创拔牙, 阻生牙, 焦虑

Abstract: PURPOSE: To evaluate the effect of nitrous oxide combined with local anesthesia in the extraction of impacted teeth and its effect on patients' anxiety. METHODS: A total of 188 patients undergoing impacted tooth extraction in Shaoxing Stomatological Hospital from December 2021 to December 2022 were selected and randomly divided into experimental group and control group, with 94 patients in each group. The control group was treated under local anesthesia, and the experimental group was treated under local anesthesia combined with nitrous oxide. The heart rate(HR), Ramsay sedation score and pain VAS score during local anesthesia, tooth extraction and 5 min after tooth extraction were compared between the 2 groups. The Modified Dental Anxiety Scale(MDAS) scores and the comfort level of patients after treatment were compared between the two groups. SPSS 22.0 software package was used for data analysis. RESULTS: With the change of treatment time, HR in both groups showed a trend of increasing at first and then decreasing (P<0.05). HR in the experimental group was significantly lower than that in the control group during local anesthesia, tooth extraction and 5 minutes after tooth extraction(P<0.05). The MDAS score of the experimental group was significantly lower than that of the control group(P<0.05). Ramsay sedation scores in both groups decreased at first and then increased with the change of treatment time(P<0.05). The Ramsay sedation score of the experimental group was significantly higher than that of the control group during local anesthesia, tooth extraction and 5 minutes after tooth extraction (P<0.05). With the change of treatment time, the VAS score of the two groups gradually increased (P<0.05). The VAS score of the experimental group was significantly lower than that of the control group during local anesthesia, tooth extraction and 5 min after tooth extraction(P<0.05). The comfort of the experimental group was significantly better than that of the control group(P<0.05). CONCLUSIONS: Nitrous oxide combined with local anesthesia for extraction of impacted teeth can reduce HR, improve patients' anxiety and sedation, reduce pain and improve comfort.

Key words: Comfortable laughing gas, Minimally invasive tooth extraction, Impacted wisdom teeth, Anxiety

中图分类号:

R782.05

康铖, 朱挺, 韩爽, 娄伊伊. 笑气联合局麻在阻生牙拔除中的应用效果评价[J]. 中国口腔颌面外科杂志, 2024, 22(2): 165-169.

KANG Cheng, ZHU Ting, HAN Shuang, LOU Yi-yi. Evaluation of the effect of nitrous oxide combined with local anesthesia in extraction of impacted teeth[J]. China J Oral Maxillofac Surg, 2024, 22(2): 165-169.

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